Dorsal cervical articular process Injection: When and how (Proceedings)

Aug 01, 2009

Figure 1. A right lateral view of a skeletal preparation of cervical vertebræ C4 and C5. See text for legend.
Osteoarthritis and cervical pain can present with clinical. Almost all skeletal preparations of horses over 18 years old have evidence of arthritic changes. The disease occurs with some frequency in horses at competitive event ages. Osteoarthritis and other degenerative changes initiated via acute or chronic trauma, or osteochondrosis of articular process articulations are common etiologies.

Ultrasonographic anatomy

Figure 2. A bone preparation and ultrasound image of the right vertebral articulation of C4 and C5. See text for legend.
Figure 1 is a skeletal preparation of C4 and C5 and depicts the gross anatomy of the structures in question. The area of synovial attachment has evidence of osteophyte formation (c). The caudal C4 facet (a) cranial C5 facet (b) and transverse process of C4 (d) are evident and labeled.

Figure 3. A method of evaluating neck flexibility.
The cervical articular facets form an identifiable ultrasonographic landmark that has the appearance of a hand with an outstretched thumb and flexed 2 first digits (Figure 2).

Figure 4. Cervical myelograph with evidence of severe degenerative changes of the right dorsal vertebral articulation of C6 to C7.
In Figure 2, the image of the hand (right) represents the ultrasonographic image. The caudal facet of C4 (C) and its transverse process (E), and the cranial facet of C5 (B) and its transverse process (D) are labeled. The ultrasound probe (A) is at the approximate scanning position as the image in the center. The ultrasound image in the center shows the bone shadows of the transverse process of C4 (E), the cranial facet of C5 (B) and caudal facet of C4 (C). The image of the hand is likewise labeled with the caudal facet of C4 (C) and its transverse process (E), and the cranial facet of C5 (B).

Identifying the site for anti-inflammatory drug injection

Physical examination specific for neck pain

Figure 5. Cervical radiograph that shows severe degenerative changes of the dorsal vertebral articulation of the C5-C6 articulation.
Physical examination of the horses with cervical neck pain indicates reduced to poor cervical flexibility. This author considers normal flexion evident when the horse's nose can be flexed to the left pant pocket with smooth motion and little hesitation. Some training may be necessary. These procedures should be performed carefully, consistently and bilaterally.


Figure 6. Ultrasonographic image of dorsal lateral cervical articulation with evidence of osteophyte formation (arrow). The caudal C5 facet (A) is evident.
Radiographic changes with little to no clinical signs have been seen by the author. Clinical However, severe pathology must be present for radiographs to be diagnostic (Figure 4, 5, and 6).